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Health Center COVID-19 Vaccine Program (HCVP) After-Action Survey
Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration
OMB: 0915-0212
IC ID: 253158
OMB.report
HHS/HSA
OMB 0915-0212
ICR 202308-0915-005
IC 253158
( )
⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0915-0212 can be found here:
2024-01-10 - Revision of a currently approved collection
2024-01-04 - No material or nonsubstantive change to a currently approved collection
Documents and Forms
Document Name
Document Type
HCVP After Action Survey Questions 4 1 22.docx
Instruction
HCVP After Action Survey Questions 4 1 22.docx
Instruction
HCVP 0990-0379-memo-fast-track-hrsa updated 42022_revised.docx
memo-fast-track
IC Document
HCVP 0990-0379-memo-fast-track-hrsa updated 42022_revised.docx
memo-fast-track
IC Document
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Health Center COVID-19 Vaccine Program (HCVP) After-Action Survey
Agency IC Tracking Number:
IC Status:
Unchanged
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Instruction
HCVP After Action Survey Questions 4 1 22.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
1,505
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits
Percentage of Respondents Reporting Electronically:
100 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,505
0
0
0
0
1,505
Annual IC Time Burden (Hours)
376
0
0
0
0
376
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
memo-fast-track
HCVP 0990-0379-memo-fast-track-hrsa updated 42022_revised.docx
04/29/2022
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.